Healthcare Provider Details

I. General information

NPI: 1669928271
Provider Name (Legal Business Name): ADVANCED HEALING WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 09/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20170 PINES BLVD 302
PEMBROKE PINES FL
33029
US

IV. Provider business mailing address

20170 PINES BLVD STE 302
PEMBROKE PINES FL
33029-1262
US

V. Phone/Fax

Practice location:
  • Phone: 754-800-2391
  • Fax:
Mailing address:
  • Phone: 754-800-2391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DR. ALDA SAINFORT
Title or Position: OWNER
Credential: MD, MDIV, OMD
Phone: 754-800-2391